Project Summary/Abstract The public charity Day Before Birth--with the support of 12 national experts, the March of Dimes, ACOG and other partners--is organizing the proposed conference to improve the health and life course of premature infants by stimulating new research, practice and policy to increase appropriate utilization of antenatal corticosteroid treatment (ACT) and by developing comprehensive recommendations for the next decade. In the US, preterm birth is the leading cause of newborn death; it is a major determinant of all infant mortality/morbidity; and it is responsible for complications that impact the health of children and their families throughout their lives. Rates of preterm birth (12.0% in 2010) continue to be well above the Healthy People 2020 objective of 11.4% -a rate that may be achievable but is still too high. For decades, the NIH, the Joint Commission, ACOG and many other leading institutions have recommended ACT treatment-offered ideally 48 hours before delivery--as one of the most effective treatments to improve the survival and health of infants born prematurely between 24 and 34 weeks gestation. Top institutions generally comply with treatment guidelines, but treatment rates are very uneven, below 25% in many communities. Out of the 170,000 women who deliver early (24-34 weeks) annually in the US, more than half deliver within 48 hours of hospital admission and therefore fail to get optimal treatment. Existing quality improvement practices, if applied, could make a difference-the prime motivation of this conference. If all eligible for ACT were fully treated, it is estimated that more than 1,000 newborn lives might be saved, a 5% reduction in neonatal mortality rates. On January 13-14 of 2014 in Washington, D.C., the conference will convene a multidisciplinary group of 50 leading experts from academia, government and the private sector; and in particular, the event will endeavor to broaden the ACT movement within the public health community and to involve women more consciously and programmatically, utilizing patient-centered care models. The conference will foster recent advances in translational research to help assure evidence-based guidelines and successful ACT quality improvement programs are implemented locally and nationally. The conference focuses on seven of the most promising areas: 1) highlight the successes and challenges of hospital and State ACT quality improvement programs; 2) understand ACT implementation barriers prior to hospital care; 3) address racial/ethnic ACT disparities; 4) formulate patient educational and advocacy campaigns; 5) improve ACT data collection; 6) promote ACT pharmaceutical research; and 7) disseminate/translate successful ACT quality improvement programs nationally. For each topic, the speaker will end the presentation with recommendations on ways the Nation might add to the current knowledge base, social strategy and political will that would significantly advance ACT treatment over the next decade. The conference will enhance the attendee's capacity to re-engineer healthcare systems, engage consumers and accelerate innovation to assure ACT treatment is consistently administered across all geographic regions, in all levels of hospitals and for all racial, ethnic and socio-economic groups.